Oral Answers to Questions

Anne Milton Excerpts

Tuesday 7th September 2010 Commons Chamber

[Mr David Hanson (Delyn) (Lab)]

5. What recent discussions he has had with the Welsh Assembly Government on the effects of proposed changes to health services in England on patients living in Wales who use those services.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Since the election, there have been informal, but no formal, discussions between my right hon. Friend the Secretary of State for Health and the Welsh Assembly Government. However, I understand that a meeting is planned for later this year. Clearly, there have been discussions between officials about the impact of the White Paper and the changes.

[Mr Hanson]

May I respectfully suggest that someone in the Government gets on and talks to the Welsh Assembly Government? A third of my constituents, who live in Wales, use the Countess of Chester hospital in England, and they use hospitals in Manchester, including the Christie and the Clatterbridge for cancer services, as well as the Robert Jones and Agnes Hunt hospital in Shropshire for orthopaedic services. They are as appalled as I am by the changes being proposed by the Conservatives to destroy the NHS. Get on and talk to someone please.

[Anne Milton]

May I thank the right hon. Gentleman for his question and assure him that officials have got on with it and do it constantly? It is important that we ensure that any changes are synchronised across the two areas, and I know that he will continue to raise cross-border issues. I can reassure him that we have already got on with it and he need not remind us to do so.

[David T. C. Davies (Monmouth) (Con)]

Given that patients in Wales, served by the Welsh Assembly, have to wait far longer for routine operations and ambulance responses, is it not the case that the only problem that the Department will face is that the people of Wales will be galvanised by the excellent policies of this Government into suggesting that the Welsh Assembly Government ditch their failed health policies and copy those of the coalition Government?

[Anne Milton]

I thank my hon. Friend for that wonderful advertisement for the changes that we are bringing in. I agree with him and I am sure that the people of Wales will see the changes that we are bringing in and contact the right hon. Member for Delyn (Mr Hanson) to urge him to ensure that the changes are also introduced in Wales.

[Hywel Williams (Arfon) (PC)]

Fourteen thousand people from Wales are registered with GPs in England, and 19,000 people from England are registered with GPs in Wales. Will the Under-Secretary ensure that the changes that she brings in do not lead to any dangers to the services provided for both sets of people travelling across the border, and that adequate financial recompense is made as well?

[Anne Milton]

It is extremely important that people receive similar and safe passage and continuity of care across the borders, and we will continue to have conversations, both at ministerial level and between officials, to ensure that any hitches that arise are smoothed out as soon as possible.

[Caroline Flint (Don Valley) (Lab)]

7. How many GPs in Doncaster have expressed an interest in establishing GP consortiums.

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[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

8. What plans he has to assist GP commissioning in rural areas.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Our proposals in the White Paper will enable general practices to structure commissioning to reflect the character of the area they serve. Practices in rural areas, such as Cumbria and Cambridgeshire for instance, are exploring commissioning models. To support GP consortiums, we will create a statutory NHS commissioning board.

[Dr Poulter]

The Minister will be aware that many women make the choice to have a home birth and delivery, but unfortunately, in many rural areas, maternity services have historically been under-resourced. What steps does the Minister envisage better to support home delivery in rural areas, and to support GPs in their commissioning of these services in the future?

[Anne Milton]

I congratulate my hon. Friend on taking up the chairmanship of the all-party group on maternity. I know that his work with it will be very valuable, particularly in the light of his previous experience in the health service. Contrary to what Labour Members believe, this is an important opportunity to put general practices—in all their shapes and forms within all the professions—at the very heart of shaping services. As he said, home births and choice in maternity services are crucial for women.

[Ann Coffey (Stockport) (Lab)]

I have concerns about the effect of the Secretary of State’s proposals for GP commissioning on services in rural areas and urban areas such as mine. Greater Manchester PCT provided strategic leadership in the recent reconfiguration of children’s services, which was very contentious. Can the Minister clarify how that strategic leadership will be provided in the future reconfiguration of cancer, maternity and ambulance services in Greater Manchester, as GP commissioning will be focused on local health needs and national commissioning on national specialities?

[Anne Milton]

The hon. Lady made the point that urban and rural areas have very different needs. What is vital are the people on the front line, making decisions and offering the leadership and vision to shape those services. I do not think that she will find many people lining up to save PCTs, whose commissioning has not always been as successful as she would like to believe.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

I should like to suggest to the Minister that it might help GPs who are commissioning in rural areas if the formula for capitation were to include the information that their patients live in sparsely populated areas, as well as information about their age, especially in constituencies such as mine and that of my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter).

[Anne Milton]

My hon. Friend is right to raise the issue of the distances covered in rural areas. I believe that only ambulance trusts currently have the opportunity to reflect that. This is why it is so important that local commissioners will shape the services for their patients. It is they, not the pen-pushers in the PCT, who know best what is right for their patients.

[Keith Vaz (Leicester East) (Lab)]

9. What steps his Department is taking to inform young people about diabetes prevention.

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[Hugh Bayley (York Central) (Lab)]

11. What recent assessment his Department has made of the clinical effectiveness of facet joint injections; and if he will make a statement.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Recommendations on facet joint injections were made by the National Institute for Health and Clinical Excellence in its 2009 clinical guidelines on low back pain. NICE did not find sufficient research evidence that strongly supported the effectiveness of facet joint injections and recommended that more research should be done. I understand that the National Institute for Health Research is looking at whether it will commission further research.

[Hugh Bayley]

Access to these injections is restricted in North Yorkshire and York PCT, although it is widely available on the NHS in other areas. The consultant in charge of York’s pain clinic believes that the PCT is not following the most recent NICE guidelines. What are the Government doing to reduce this kind of postcode lottery? Will the Minister contact the PCT and arrange for it to meet me and the consultant to discuss how these guidelines ought to be applied in North Yorkshire and York?

[Anne Milton]

I thank the hon. Gentleman for his remarks and point out that it is precisely because of the situation that he describes that we are bringing in some of our reforms. It is important that decisions about treatment and care are made by clinicians—GPs and a large number of other people, including some voluntary and charitable organisations—and that they are clinically led, evidence-based and also include patient choice.

[Mr Charles Kennedy (Ross, Skye and Lochaber) (LD)]

12. What recent discussions he has had on the effectiveness of the National Institute for Health and Clinical Excellence’s procedures to review the cost-effectiveness of drugs; and if he will make a statement.

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[Andrea Leadsom (South Northamptonshire) (Con)]

16. What recent representations he has received on requirements for doctors to record the primary cause of death on a death certificate.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

I am not aware of any such representations. Doctors are required under the Births and Deaths Registration Act 1953 to complete the medical certificate of cause of death “to the best” of their “knowledge and belief”. They receive information on this as part of their medical training. The Office for National Statistics produces reference material from time to time, including a video and training pack to assist doctors in completing the medical certificate on cause of death.

[Andrea Leadsom]

I thank the Minister for that answer. We have in my constituency of South Northamptonshire the Progressive Supranuclear Palsy Association headquarters. That is a neuro-degenerative disease with some similarities to motor neurone disease, although the big difference is that I doubt that many Members will have heard of it before now. Many people suffer from it, however, yet it is often not recorded on the death certificate. It is always fatal, giving a life expectancy of about two years. Might the Minister be prepared to review the situation and give some consideration to requiring doctors to put the primary cause of death on the death certificate so that we can properly assess the magnitude of this awful degenerative disease?

[Anne Milton]

I thank my hon. Friend for raising this issue. As a result of inquiries from the Progressive Supranuclear Palsy Association and others, the ONS is carrying out a special exercise to attempt to identify the true number of deaths involving PSP. However, it is extremely difficult to diagnose. I should just point out that medical examiners, when appointed, will be confirming the cause of death in all cases not investigated by the coroner. I think that that will make a difference to the information recorded on death certificates.

[Caroline Flint (Don Valley) (Lab)]

T1. If he will make a statement on his departmental responsibilities.